Program Profile: Families Facing the Future

Study Title: Experimental Intervention With Families of Substance Abusers: One-Year Follow-Up of the Focus on Families Project (which is associated with outcomes Parental drug use, Alcohol Use, Marijuana use, and Household rules)

Research Design/Sample

Catalano and colleagues (1999) used a randomized experimental design to evaluate the effect of Families Facing the Future (known at the time as Focus on Families) on parental drug use, parenting skills, and the prevention of drug and alcohol use by their children. Participants were recruited while in two methadone clinics in Seattle, WA. To be eligible for the study, participants had to have been in treatment for at least 90 days, have at least one child between the ages of 3 and 14 who lived with them at least 50 percent of the time, and live within 25 miles of the methadone clinic. There were 130 families enrolled and randomized into treatment (n = 75) or control (n = 55) groups. There were 144 methadone-treated parents and 178 children (treatment n = 97, control n = 81) included in the 130 families. Families in the treatment group received methadone services plus the supplemental Families Facing the Future services, while families in the control received methadone services with no supplemental services. Standard methadone services included methadone dispensing and some individual and group counseling.

Participating parents were mostly white (77 percent), female (75 percent), between the ages of 29 and 41, and longtime opiate users (15 years or more). While 60 percent of the parents lived with their partner or spouse, only 20 percent were married. A little more than half (54 percent) of the parents reported any illicit drug use in the month before baseline. Parents had spent an average of 15 months in methadone treatment before enrollment. Sixty-eight percent of the parents had been incarcerated at some point in their lives, and 66 percent had been unemployed in the last 3 months before their participation. Participating children were ages 8 to 12. Families were grouped into blocks based on race, parents’ age at first drug use, whether parents lived with a spouse or partner, and ages of children before randomization. Families within blocks were randomly assigned to the treatment or control condition with a higher proportion assigned to the treatment condition. There were no statistically significant differences between treatment and control groups at baseline.

Data Collection/Outcome Measures

Parents were assessed at baseline, posttest, 6 months, and 12 months. Children were assessed at baseline, 6 months, and 12 months. The CrimeSolutions review of this study focused on results at the 12-month follow-up for both parents and children. Developmentally appropriate interviews were used for the age groups 6–8, 9–10, and 11 and older based on age at time of interview. Data was presented for children in the 9–10 and in the 11 and older groups. 

The study examined the program’s impact on parental drug use, parenting skills, and children’s use of alcohol and marijuana. Parental drug use (self-report) was a combined measure of how many times a parent used marijuana, heroin, or cocaine in the previous month. In addition, 25 percent of the participating parents were randomly selected to provide a urine sample to test the validity of the self-reports. There were few false negatives, and there was no significant difference between false negatives in the treatment and control groups. Parents were also asked about household rules (whether their household had rules regarding items such as television, chores, or drug use). Children’s alcohol use was assessed by asking children whether they drank alcohol (more than a sip) in the previous 6 months, and their marijuana use was assessed by asking whether they used marijuana in the previous month. 

Statistical Analysis

All outcomes were examined using analysis of covariance and logistic regression. Subgroup analyses were not conducted.

Citation: Catalano, Richard F., Randy R. Gainey, Charles B. Fleming, Kevin P. Haggerty, and Norman O. Johnson. 1999. “An Experimental Intervention With Families of Substance Abusers: One-Year Follow-Up of the Focus on Families Project.” Addiction 94(2):241–54.

This study is a high-quality randomized controlled trial.

Study Title: Long-Term Effects of the Focus on Families Project on Substance Use Disorders Among Children of Parents in Methadone Treatment (which is associated with outcomes Alcohol Use, Alcohol dependence, Any substance abuse , Cocaine/amphetamine abuse , Opiate abuse , Marijuana use, and Dependence on drugs)

Research Design/Sample

Haggerty and colleagues (2008) conducted a follow-up of the Catalano and colleagues (1999) study to examine the impacts of the Families Facing the Future intervention 12 to 15 years after initial participation. Of the original sample, evaluators were able to locate 151 of the original 178 children. Since the sample was of families and included siblings, one child from each family was randomly selected for inclusion in the analysis, leaving a total final sample of 126 children at follow-up (treatment n = 71, control n = 55).

At follow-up, children were mostly male (55 percent) and were ages 15 to 29, with an average age of 22. There were statistically significant differences between the groups; there were more white children in the treatment group (67 percent) than in the control group (48 percent), despite parents’ being block randomized on race during the original randomization, and mortality rates (added as a control variable) at follow-up were higher for parents of the intervention group (32 percent) than for the control (13 percent).

Outcome Measures/Data Collection 

Substance abuse disorders (abuse of alcohol, marijuana, opiates, cocaine/amphetamines, hallucinogens and inhalants, or any substance, and alcohol dependence) as described by the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV) were measured using the Composite International Diagnostic Interview. Dependence on drugs was a combined measure of dependence on any substance, marijuana, opiates, or cocaine/amphetamines.

Statistical Analysis

A Cox proportional hazard model was used to assess the outcomes, and an intent-to-treat analysis was conducted. Subgroup analyses were conducted to examine the possible interactions that sex had on the impact of the intervention.

Citation: Haggerty, Kevin P., Martie L. Skinner, Charles B. Fleming, Randy R. Gainey, and Richard F. Catalano. 2008. “Long-Term Effects of the Focus on Families Project on Substance Use Disorders Among Children of Parents in Methadone Treatment.” Addiction 103:2008–16.

This study is a high-quality randomized controlled trial.